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Advanced Pharm Exam 2 > Analgesics > Flashcards

Analgesics Flashcards

1
Q

NSAIDS MOA

A

inhibit formation of various prostaglandins & decrease pain impulses received by the CNS

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2
Q

COX-1 physiologic effects

A

gastroprotective prostaglandings, thromboxane A2, vasodilation of renal blood vessels

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3
Q

COX-2 physiologic effects

A

pain, inflammation, antithrombosis, vasodilation of renal blood vessels

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4
Q

non-selective NSAIDS MOA and examples

A

inhibit cox-1 and cox-2

diclofenac
ibuprofen
ketorolac
naproxen

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5
Q

partially selective NSAIDS MOA and examples

A

inhibit cox-2 only (but inhibit both at higher levels)

celecoxib
meloxicam

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6
Q

AE of NSAIDs

A

gastric irritation, renal dysfunction, platelet inhibition, increased risk of CV events, fluid retention, may alter effects of aspirin

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7
Q

acetaminophen MOA

A

inhibits COX-1 an COX-2 in CNS (not periphery) & decreases pain impulses received by the CNS

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8
Q

tool used to estimate hepatotoxicity toxicity from acute acetaminophen OD?

A

rumack-matthew nomogram

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9
Q

when should long-acting/ER opioids be used?

A

pain requiring around-the clock long term treatment

not as needed

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10
Q

schedule I meds

A

high abuse potential

ecstasyy, heroin, LSD

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11
Q

schedule II meds

A

high abuse potential

codeine, fentanyl, hydrocodone, hydromorphone, methadone, meperidine, morphine, oxycodone

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12
Q

schedule III meds

A

moderate abuse potential

acetaminophen with codeine, ketamine

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13
Q

schedule IV meds

A

low abuse potential

tramodol

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14
Q

immediate-release oral opioid use & examples

A

moderate to severe pain

morphine
oxycodone
tramadol

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15
Q

IV opioids that should be avoided w renal dysfunction

A

meperidine

morphine

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16
Q

methadone MOA

A

pain receptor agonist, NDMA receptor antagonist, and 5HT and NE reuptake inhibitor

17
Q

precautions for methadone

A

numerous drug interactions
monitor QTC
do not titrate > q 5 days

18
Q

common AEs of opioids

A

autonomic - xerostomia, urinary retention, postural hypotension

CNS - resp depression, confusion, hallucinations, decreased cough reflex

cutaneous - pruritis, sweating, flushing

GI - N/V/C, ileus, obstruction

19
Q

recommended meds for opioid-induced constipation

A

scheduled senna or bisacodyl

polyethylene glycol, MOM

20
Q

available naloxone routes

A

IV, IM, SQ, IN, NEB, IO, ET

21
Q

s/s of opioid withdrawal

A

N/D, coughing, lacrimation, yawning, sneezing, rhinorrhea, sweating, muscle twitching, piloerection, hot/cold flashes, muscle cramps

22
Q

long term AE of opioids

A

addiction, physical dependence, tolerance, pseudoaddiction

23
Q

adjuvant pain therapies

A 
muscle relaxants
systemic lidocaine
ketamine
dexmedetomidine
anticonvulsants
TCAs
SNRIs
topical agents
24
Q

common muscle relaxants

A

baclofen - antispasmotic
cyclobenzaprine
methocarbamol
tizanidine

25
Q

lidocaine MOA

A

Na channel blocker used as adjuvant pain therapy

26
Q

ketamine MOA and use

A

NMDA receptor antagonist

pain adjuvant therapy helps lower opioid consumption by 40%

27
Q

AE of ketamine

A

psychomimetic effects
HTN, tachycardia

does not cause resp depression at normal pain dosages :)

28
Q

dexmedetomidine

A

A2-adrenergic agonist

29
Q

anticonvulsants used as adjuvant pain therapy

A

gabapentin, pregabalin

30
Q

TCAs used as adjuvant pain therapy

A

nortriptyline

amitriptyline

31
Q

SNRIs used as adjuvant pain therapy

A

duloxetine

venlafaxine

32
Q

therapy for nociceptive pain

A

1 - NSAID
2 - duloxetine or TCA
3 - opioid

33
Q

therapy for neuropathic pain

A

1 - gabapentin, pregabalin, SNRI or TCA + topical lidocaine
2 - tramodol or combo first line therapies
3 - pain specialist referral

34
Q

therapy for cancer pain

A

nociceptive - non-opiods + opioids/adjuvants

neuropathic - opioids + gabapentin, pregabalin, SNRI or TCA

35
Q

therapy for bone pain

A

NSAIDS + opioids

adjuvants

Advanced Pharm Exam 2 (3 decks)

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